Yoga is as Effective as Physical Therapy for Chronic Low Back Pain

A study published in a highly-respected journal, Annals of Internal Medicine, demonstrated that yoga was as good as physical therapy for chronic lower back pain management in a diverse, predominantly low-income population.

Studies show that yoga is effective for treating low back pain, however it is not clear how it compares with standard treatments for chronic low back pain that are covered by health insurance, such as physical therapy. The study from Boston and Harvard medical schools tried to establish if yoga, as “new” therapy is statistically as effective as an accepted treatment (physical therapy). This is useful as yoga may have other potential benefits, such as lower cost.

The study was conducted in 12-week, using a single-blind, 3-group randomized noninferiority trial and subsequent 40-week maintenance phase. The setting is in an academic safety-net hospital and 7 affiliated community health centers. The study recruited 320 predominantly low-income, racially diverse adults with nonspecific cLBP. Participants were randomised to receive either a 12 weekly yoga classes, 15 PT visits, or an educational book and newsletters. The maintenance phase compared yoga drop-in classes versus home practice and PT booster sessions versus home practice. Primary outcomes were back-related function, measured by the Roland Morris Disability Questionnaire (RMDQ), and pain, measured by an 11-point scale, at 12 weeks. Secondary outcomes included pain medication use, global improvement, satisfaction with intervention, and health-related quality of life.

The outcomes showed that participants in the yoga and physical therapy groups showed similar improvements in levels of pain and activity limitations. Yoga may be another reasonable option for treating chronic low back pain.The outcomes demonstrated that yoga is as good as PT, but, yoga was not superior to education for either outcome. Nevertheless, Yoga and PT participants had greater improvement in function and pain than education participants. Yoga and PT participants were less likely to use pain medication at 12 weeks compared to education participants. Improvements in yoga and PT groups were maintained at 1 year with no differences between maintenance strategies. Frequency of adverse events, mostly mild self-limited joint and back pain, did not differ between the yoga and PT groups.

The authors also stated the limitations of this study, i.e. participants knew what treatments they were receiving, and the participants attended a low number of yoga and physical therapy sessions.

The authors concluded that a manualized yoga program for nonspecific cLBP showed similar improvements in function and pain as PT.